abstract: 'Background Helmet use among bike-share users is low. We sought to characterize helmet-use patterns, barriers to helmet use, and cycling safety practices among bike-share users in Toronto. Methods A standardized survey of public bike-share program (PBSP) users at semi-random distribution of PBSP stations was undertaken. By maintaining a ratio of one helmet-wearer (HW): two non-helmet-wearers (NHW) per survey period, we controlled for location, day, time, and weather. Results Surveys were completed on 545 (180 HW, 365 NHW) unique users at 48/80 PBSP locations, from November 2012 to August 2013. More females wore helmets (F: 41.1\%, M: 30.9\%, p=0.0423). NHWs were slightly younger than HWs (NHW mean age 34.4 years vs HW 37.3, p=0.0018). The groups did not differ by employment status, education, or income. Helmet ownership was lower among NHWs (NHW: 62.4\% vs HW: 99.4\%, p<0.0001), as was personal bike ownership (NHW: 65.8\%, vs HW: 78.3\%, p=0.0026). NHWs were less likely to always wear a helmet on personal bikes (NHW: 22.2\% vs HW: 66.7\%, p<0.0001), and less likely to wear a helmet always or most of the time on PBSP (NHW: 5.8\% vs HW: 92.3\%, p<0.0001). Both groups, but more HWs, had planned to use PBSP when leaving their houses (HW: 97.2\% vs NHW: 85.2\%, p<0.0001), primarily to get to work (HW: 88.3\% vs NHW: 84.1\%, p=0.19). NHWs were more likely to report that they would wear a helmet more (NHW: 61.4\% vs HW: 13.9\%, p<0.0001), and/or cycle less (NHW: 22.5\% vs HW: 4.4\%) if helmet use was mandatory. Conclusions PBSP users surveyed appear to make deliberate decisions regarding helmet use. NHWs tended to be male, slightly younger, and less likely to use helmets on their personal bikes. As Toronto cyclists who do not wear helmets on PBSP generally do not wear helmets on their personal bikes, interventions to increase helmet use should target both personal and bike-share users. Legislating helmet use and provision of rental helmets could improve helmet use among bike-share users, but our results suggest some risk of reduced cycling with legislation. Resume Contexte Peu d''usagers des services de partage de velos portent le casque. Aussi les auteurs ont-ils cherche a caracteriser les habitudes du port du casque, les obstacles a son utilisation et les pratiques en matiere de securite parmi les usagers du service de partage de velos a Toronto. Methode Une enquete normalisee a ete menee parmi les usagers du programme public de partage de velos (PPPV), a differentes stations, choisies selon une repartition semi-aleatoire. Les auteurs, en maintenant constant le rapport de un porteur de casque (PC)/deux non-porteurs de casques (NPC) par periode d''enquete, ont neutralise les variables relatives au lieu, au jour, a l''heure et au temps (conditions meteorologiques). Resultats L''enquete a porte sur 545 (180 PC; 365 NPC) usagers differents, a 48/80 stations, de novembre 2012 a aout 2013. Les femmes (F) etaient plus nombreuses que les hommes (H) a porter le casque (F: 41,1 \%; H: 30,9 \%; p=0,0423). Les NPC etaient un peu plus jeunes que les PC (NPC: 34,4 ans en moyenne contre {[}c.] PC: 37,3 ans en moyenne; p=0,0018). Par contre, il n''y avait pas de difference entre les groupes quant a la situation de l''emploi, aux etudes ou au revenu. Le fait de posseder son propre casque etait plus faible parmi les NPC (NPC: 62,4 \% c. PC: 99,4 \%; p<0,0001) que parmi les PC, tout comme le fait de posseder sa propre bicyclette (NPC: 65,8 \% c. PC: 78,3 \%; p=0,0026). Les NPC avaient moins tendance a toujours porter un casque sur leur bicyclette personnelle (NPC: 22,2 \% c. PC: 66,7 \%; p<0,0001) et a toujours ou presque toujours porter un casque sur les bicyclettes du PPPV (NPC: 5,8 \% c. PC: 92,3 \%; p<0,0001). Dans les deux groupes, mais davantage dans celui des PC, les cyclistes avaient prevu recourir au PPPV au depart de la maison (PC: 97,2 \% c. NPC: 85,2 \%; p<0,0001), surtout pour se rendre au travail (PC: 88,3 \% c. NPC: 84,1 \%; p=0,19). Les NPC etaient plus nombreux que les PC a indiquer qu''ils porteraient le casque plus souvent (NPC: 61,4 \% c. PC: 13,9 \%, p<0,0001) et/ou qu''ils feraient moins de bicyclette (NPC: 22,5 \% c. PC: 4,4 \%) si le port du casque devenait obligatoire. Conclusions Les usagers du PPPV ayant participe a l''enquete semblent avoir fait un choix delibere quant au port du casque. Les NPC etaient en general des hommes, un peu plus jeunes que les PC et les premiers avaient moins tendance que les seconds a porter un casque sur leur bicyclette personnelle. Comme les cyclistes qui ne portent pas de casque sur les bicyclettes du PPPV n''en portent generalement pas sur leur bicyclette personnelle a Toronto, les interventions visant a accroitre le port du casque devraient viser autant les proprietaires de bicyclette personnelle que les usagers du service de partage de velos. Toutefois, le fait d''imposer le port du casque et la fourniture de casques de location par voie legislative pourrait certes ameliorer le port du casque parmi les usagers du service de partage de velos, mais, d''apres les resultats de l''enquete, cela pourrait aussi avoir pour consequence de diminuer l''usage de la bicyclette.' affiliation: 'Friedman, SM (Corresponding Author), Univ Hlth Network, Dept Emergency Med, RFE G S434,200 Elizabeth St, Toronto, ON M5G 2C4, Canada. Friedman, Steven Marc; Cleiman, Paula, Univ Hlth Network, Dept Emergency Med, RFE G S434,200 Elizabeth St, Toronto, ON M5G 2C4, Canada. Friedman, Steven Marc; Adamson, Matthew; Arenovich, Tamara, Univ Toronto, Fac Med, Toronto, ON, Canada. Oleksak, Karolina; Mohabir, Ishmael Michael, Univ Toronto, Fac Sci, Toronto, ON, Canada. Ta, Robert, Univ Dublin Trinity Coll, Sch Med, Dublin, Ireland. Reiter, Kimberley, Univ Ottawa, Fac Med, Ottawa, ON K1N 6N5, Canada.' author: Friedman, Steven Marc and Adamson, Matthew and Cleiman, Paula and Arenovich, Tamara and Oleksak, Karolina and Mohabir, Ishmael Michael and Ta, Robert and Reiter, Kimberley author-email: steven.friedman@uhn.ca author_list: - family: Friedman given: Steven Marc - family: Adamson given: Matthew - family: Cleiman given: Paula - family: Arenovich given: Tamara - family: Oleksak given: Karolina - family: Mohabir given: Ishmael Michael - family: Ta given: Robert - family: Reiter given: Kimberley da: '2023-09-28' doi: 10.1017/cem.2015.22 eissn: 1481-8043 files: [] issn: 1481-8035 journal: CANADIAN JOURNAL OF EMERGENCY MEDICINE keywords: bicycle helmets; bicycling Injuries; bike lanes; bike share keywords-plus: BICYCLE SAFETY; LEGISLATION; PREVALENCE; VICTORIA; MONTREAL language: English month: JAN number: '1' number-of-cited-references: '42' orcid-numbers: Ta, Robert/0000-0002-2204-1810 pages: 28-36 papis_id: 4b57fb5b7471491e11594979cfe1bf83 ref: Friedman2016helmetwearingpractic times-cited: '12' title: 'Helmet-Wearing Practices and Barriers in Toronto Bike-Share Users: a Case-Control Study' type: article unique-id: WOS:000368765600004 usage-count-last-180-days: '0' usage-count-since-2013: '28' volume: '18' web-of-science-categories: Emergency Medicine year: '2016'